Kenneth Kessler, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MED-PAC-LIC-42349 Issued in MT

Practice address

500 W Broadway St
Missoula, MT 59802-4008

Phone

(406) 329-5615

Fax

(406) 329-5606

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services Mt

  dba St Patrick Hospital Rehab

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment
• Providence Health & Services Mt

  dba Providence Medical Group Montana

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD
• Providence Health & Services Mt

  dba Providence Medical Group Montana

  • Clinical Medical Laboratory
  • Missoula, MT
  • NPI 1316605637
  NPD
• Good Samaritan Hospital Corvallis

  dba Samaritan Cardiothoracic Surgery - Corvallis

  • Cardiovascular Disease Physician
  • Corvallis, OR
  • NPI 1801148861
  NPD
• Missouri Basin Anesthesia, PLLC

  • Anesthesiology Physician
  • Bismarck, ND
  • NPI 1952413585
  NPD (past)
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F

  • General Acute Care Hospital
  • Chippewa Falls, WI
  • NPI 1164429908
  NPD (past)
• St. Alexius Heart & Lung Clinic, LLC

  • Cardiovascular Disease Physician
  • Bismarck, ND
  • NPI 1194823021
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1538250246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303738",
            "country_code": "US",
            "telephone_number": "541-768-5223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "KENNETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA187906",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ND",
            "license": "PAC0184",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "MED-PAC-LIC-42349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538250246",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00271582",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkessleragency214595@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lilian Kennedy
• Veronica Kenney, MS, CCC-SLP
• Christian Randall Kenworthy, D.D.S, M.S.
• Michael Kerns, DPT
• Jennifer Lynn Kessler, O.D.
• Lawrence G Kettwich, M.D.
• Kevin a. Miltko DDS
• Key Therapy, LLC (Key Therapy)
• Miles Roe Key, MSPT
• Jennifer Keys, LCSW

• Surgical Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Surgical Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.